An all-Thai team analyzed co-authorship structures in five leading Q1 health-professions-education journals from 2015 through 2024, covering 13,187 publications, 45,366 authors, and affiliations in 162 countries. Annual output grew 2.7-fold and distinct authors 3.7-fold. High-income-country-only publications fell from 86% to 63%, while non-high-income-only publications rose from 6% to 26%. The network became broader and more connected, yet the United States, United Kingdom, and Canada remained central, and low-income-country collaboration was more often routed through high-income partners than through regionally led networks.
Key findings
- The dataset comprised 13,187 publications, 45,366 authors, and 162 countries. Annual output increased 2.7-fold and distinct annual authors 3.7-fold from 2015 to 2024.
- High-income-only articles declined from 86% to 63%, while non-high-income-only articles rose from 6% to 26%. More than 60% of high- and upper-middle-income output still involved no international collaboration.
- High-income countries appeared in 70% of internationally collaborative publications, and 45% were exclusively HIC–HIC. Low-income countries appeared in 164 collaborative papers, 65% partnered with HICs.
- There were 41 UMIC–LMIC papers, 11 LMIC–LIC papers, and no cross-country LIC-only co-authored publications. Participating countries rose from 72 to 162, links nearly tenfold, and network density from 8% to 14%.
- The small-world coefficient fell from 8.55 to 4.39, modularity from 0.200 to 0.172, and homophily from 0.53 to 0.39. Greater cross-group connection was driven partly by LIC–HIC links rather than LIC-led networks.
Why this matters globally
The analysis shows that global participation is broadening, while simple country or publication counts can conceal dependence on established hubs. Journals, funders, and research networks can use these indicators to monitor South–South collaboration, low-income-country leadership, and brokerage. Co-authorship position remains only a structural proxy: it cannot establish who sets agendas, controls funds, receives credit, or holds editorial authority.
Thai researcher contribution
All eight authors are Thai-affiliated: seven with Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, and Somsak Chunharas with the National Health Foundation of Thailand. The Thai team designed and performed a global equity analysis rather than serving as a data-collection site. The article credits Peerasit Sitthirat with concept and methods, Sitthirat and Seksan Yoadsanit with analysis, and the remaining team with discussion, supervision, and writing roles as reported.
Limitations to consider
Country-affiliation nodes flatten author order, institutional hierarchy, individual inequality, and the distinction between nationality and workplace. SNA captures structure but not symbolic, normative, or experiential dimensions. Restriction to five high-impact English-language Q1 journals underrepresents regional, non-English, and lower-impact outlets, so the study characterizes a dominant tier rather than the entire field. Co-authorship metadata cannot determine agenda-setting, funding control, editorial authority, or who benefits.